Higher collateral damage found with pulsed-field ablation: 4 study notes

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Collateral effects on non-target tissue are worse with pulsed-field ablation than with radiofrequency ablation, according to a study published April 24 in JACC: Clinical Electrophysiology

The multicenter study, led by researchers from the Kansas City (Kan.) Heart Rhythm Institute, analyzed data from 871 patients who underwent pulsed-field ablation or radiofrequency ablation beginning March 2024 and onward.

Here are four notes on the study:

  1. Of the 773 patients who underwent pulsed-field ablation, 70.9% were with a pentaspline system, 14.1% with a circular multielectrode, 12.4% with a spherical and 2.3% with a variable loop catheter.
  2. Post-procedural changes associated with pulsed-field ablation included higher levels of troponin, lactate dehydrogenase and haptoglobin biomarkers, compared to the levels associated with radiofrequency ablation.

    These changes were dose-dependent and varied across the pulsed-field ablation systems used.
  3. There was also significant change in left atrial ejection fraction associated with pulsed-field ablation compared to radiofrequency ablation, at -5.0% and -20.0%, respectively.
  4. “As [pulsed-field ablation] becomes mainstream, future studies appraising these effects and understanding the short term and long-term implications are needed,” the study authors wrote. 

Read the full study here

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